title: Pain experienced by patients during minimal-invasive ultrasound-guided breast biopsy: vacuum-assisted vs core-needle procedure.
abstract: OBJECTIVE
  To evaluate comparatively the pain associated with ultrasound-guided core-needle (CN) and vacuum-assisted (VA) biopsy for non-palpable breast lesions.
  
  
  METHODS
  723 women undergoing ultrasound-guided breast biopsy for BIRADS IV and V lesions according to the same standardised protocol were prospectively studied. 14-gauge CN biopsy with an automated gun was performed in 321 patients. In 402 women biopsy was made using 11-gauge VA hand-held probe. Immediately after the procedure patients were interviewed about the pain experienced during the biopsy and were asked to indicate at the pain intensity on a eleven-point scale: from 0 (none) to 10 (extreme, worst possible pain).
  
  
  RESULTS
  The median rate of pain experienced by women during biopsy was 4 (range 2-7). There were no significant differences between CN and VA groups with regard to age, body mass index, menopausal status, history of parity, hormone replacement therapy, menopausal status, breast parenchymal pattern (according to Wolfe's classification), family history of breast cancer, lesion size and number of samples. CN biopsy with an automated gun was significantly more painful (P < 0.01) than procedure with VA hand-held device as evaluated by patients: median 6 (4-7) vs 3 (2-5), respectively.
  
  
  CONCLUSIONS
  Despite using the larger needle VA procedure results in less pain experienced by women in comparison to CN biopsy with automated gun. Reduced patient discomfort should be one of the reasons for the preferential use of VA biopsy in the assessment of non-palpable breast masses.
authors.affiliation: 2nd Department of Surgical Oncology, Lower Silesian Oncology Centre, Regional Comprehensive Cancer Centre, Wroclaw, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Szynglarewicz
authors.forename: R
authors.initials: R
authors.lastname: Matkowski
authors.forename: P
authors.initials: P
authors.lastname: Kasprzak
authors.forename: J
authors.initials: J
authors.lastname: Forgacz
authors.forename: A
authors.initials: A
authors.lastname: Zolnierek
authors.forename: A
authors.initials: A
authors.lastname: Halon
authors.forename: J
authors.initials: J
authors.lastname: Kornafel
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods*; D001941:Breast Diseases / Q000175:diagnosis / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement; D010173:Palpation; D011446:Prospective Studies; D012107:Research Design; D011795:Surveys and Questionnaires; D016217:Ultrasonography, Mammary; D014618:Vacuum